On The Importance of Open Debate

Following the sustained pressure Conway Hall faced due to the nature of the Radfem 2012 article, it was today revealed that Shelia Jeffreys has been banned from speaking at the conference due to the controversial nature of her so-called hate speak. In her article today published in the Guardian as part of their “comment is free” series, she seeks largely to rebut the criticism that she and her supporters have faced in the wake of the discriminatory admissions policy of the conference, singling out Roz Kaveney’s article in particular.

Whilst I am certain that many of “my sisters” will be rejoicing at this news – and I imagine a number of pieces of this nature will have been published online as this was being written – this is not what interests me today. Instead, it seems to me that there is an arguably more important issue about the nature of free speech being raised in Ms Jeffreys’ article (disingenuous and somewhat ironic though it might have been in this context) which has been bubbling below the surface for sometime. It is this same issue which made me unwilling to call for her being “banned” from speaking at this conference, and consequently I am unhappy with this outcome. Personally, impossible though this solution might have been, I would have much preferred to see the inclusion of women who are trans at Radfem 2012 so that, were Ms Jeffreys to raise the issue, a balanced discussion could potentially have been had.

The fact of the matter is that gender identity disorder (aka transsexualism, transgenderism or gender incongruence depending on which nomenclature your prefer) is a hugely under-researched area and, consequently, one which we know little about. We have little to no idea of its cause or how it progresses, and as such it is a ‘condition’ [a term I use *very* loosely here] which is normally diagnosed by the patient as opposed to a doctor. This means that when someone presents with gender incongruence it falls upon the psychiatrist to confirm the diagnosis rather than make the diagnosis themselves. Doctors are human and not infallible; as such medical professions are as able to be lead by information as anyone else. In a situation such as with gender incongruence where there is empirical test to confirm available, this process becomes much more difficult and time consuming as the doctor cannot run the risk of causing idiopathic harm through the misdiagnosis and subsequent mis-treatment.

Were more research done into gender identity disorder we would naturally learn more about the ‘condition’. Consequently, we would be able confirm the diagnosis more effectively. This would potentially not only allow for those people on the treatment pathway to progress more quickly and less disruptively, but it may also help to facilitate a better understanding at a more local level thus ensuring more accurate (i.e. less false) and faster referrals onto the pathway for those seeking treatment.

So, with this in mind, why do we [individuals who are trans] as a community seem to be so afraid to have this discussion? Whilst I do not agree with the tone of her article, Ms Jeffreys gives a number of examples – both recent and not – of occasions in which we have indeed subjected those who question the nature of gender identity disorder “to determined campaigns of bullying, intimidation and attempts to shut them down” . Whilst many may argue these campaigns were justified, I would point out that it is not the campaigns themselves which are objectionable but rather their nature. The nature of these acts not only undermines the associated campaigns, but also serves to highlight the desperation and defensiveness we appear to feel when questioned. Yet, if we will fight for our rights – thus effectively forcing others to re-evaluate our role in society; is it not only fair that we allow them to freely question that role?

By taking the defensive and dismissive stance we serve not only to empower the argument – as Ms Jeffreys suggests – that gender incongruence “might not stand up to rigorous research and debate”, but we also stifle any chance of progress in terms of our treatment by medical professionals, our treatment by academics and – in many ways – our treatment by the general populous, since those who might facilitate that progress are left too afraid to enter the field by the fallout of ongoing battles. If we were instead to step back and allow outspoken individuals to say their piece and move on, we might slowly be able to replace these childish squabbles and vicious conflicts with productive, intellectual discussion and progressive research. As in any area, as the discussion grows and debate continues those with more extreme views and theories will be largely marginalised, dismissed and unheard – and so disarmed anyway. Moreover, if we actually go one further and actively arrange and facilitate debate in this way then we may even be able to shape the nature and focus of discussion to meet our own ends.

The crux of my argument is this – those coming forth with new and differing views should be met with open minds; not with open warfare. Whilst it would be foolish to through caution to the wind in its entirety, it appears that for the moment the approach being taken is not one which even permits whispers to go uncensored. As such it might be prudent to take a step back in order to allow a dialogue to begin and instead aim to steer it as it matures. Yes, a number of controversial views may currently be present, but in facilitating discussion I am certain we will find that things are much more interesting just below surface. The potential for discussion here is like an iceberg – let us help it to be explored fully.

On Removing Ignorance in Healthcare

Over the past few years, it would be fair to say that I have heard my fair share of Transgender healthcare related horror stories; both those that are whispered on the wind and passed around as tales of warning to those who might dare attempt transition, and those deeply personal first hand accounts which I have felt honoured to be trusted with. These stories pertain to all areas of healthcare; from refused blood-tests due to poorly completed gender markers, to people being asked to leave by GPs; from avoidance (and essentially covert refusal) of treatment by certain GICs, to other peoples’ impossible struggle to get onto the pathway in the first place.

What disturbs me about this, however, is not the nature of the tales but rather the sheer quantity. It dawned on me recently that over the course of the average week it is rare that I don’t hear a first hand account of – what the government might try to describe as – “poor experiences of the NHS” by individuals who are trans. These may be minor in nature – for example, a trans woman having to explain multiple times that she didn’t have a uterus – or significantly more major – for example. transphobic abuse by hospital staff. In either case this appalling and as a healthcare professional myself I can honestly say this should not be happening.

Relatively recently, a medical student was published in the student lancet calling for LGBT issues to be added to medical school curricula in order to raise awareness amongst future doctors and thus reduce discrimination. Since this could be quite easily incorporated into medical school teaching [Just to clarify, doctors are taught a lot of social science already (which includes similar topics such as ethnicity), not simply hard science] it is an example of a suggestion which could be easily realised and could potentially make a huge difference. It is small suggestions of this nature which we – by which I not only mean the trans community, but also the medical community – should really be pushing for. I am not saying that this alone would be enough to change the current picture of discrimination, but if combined with getting other similar small stones rolling then it definitely has the potential to turn into a landslide.

If we were to pursue this idea, it would be both unfair and unrealistic – not to mention go against my own experiences – to say that all transphobia which occurs in healthcare is orchestrated by doctors (for those of you less familiar with this, for specific examples and to get a feel for just how broad the source of discrimination is you do not need to go further than Press For Change’s 2007 Engendered Penalties Document which has numerous examples). As such, pressure would also need to be put on other healthcare professions – such as nursing – at an institutional level to likewise incorporate this into teaching, and hopefully improve nursing for the next generation of transgender individuals. By targeting the individual components of our healthcare system in this manner, we could potentially remove the ignorance surrounding transgender issues and tackle a source of our discrimination.

Education is a valuable and often underrated tool in instigating change. In many ways, the issue with education – and the reason it is often overlooked – is that it takes a long time between implementation and for the results to be seen; often far exceeding patience. As such, when it is used it needs to be combined with short term strategies which aim to address the issue of the problem as it currently stands – in this case, this could be done through raising awareness and pushing for training for current staff – and to challenge issues on an individual level as they arise in order to make sure that transphobia in healthcare never gains [or regains] an air of acceptability. I feel these 2 strands will combine to give a small and short-term change, which the education of training healthcare professionals will be able to use as a platform to build upon to generate sustained change.

It may not be the fastest process, and even with the addition of short term awareness raising strategies it mays still take a generation before we see change, but if you were asked to sacrifice happiness today for the guarantee of a brighter future for everyone, wouldn’t you?

On Radfem Explicit Exclusion of Trans Women

I’ve been reading a lot about the whole Rad-fem vs. Trans Activist debacle lately, which has once again been exacerbated – this time by the explicit exclusion transgendered individuals at Radfem 2012 through the use of the phrase “women born women living as women”. It’s an interesting phrase in itself; if you were to take it as law it would also exclude anyone who might consider themselves to live androgynously as well as – to use that classic shakespearean twist – anyone born by a caesarian section. The intent, however, remains clear – the exclusion of women who are also trans.

I should make something clear at this point, clunky though this phrasing is I am “a woman who is also trans”. I would not choose to describe myself – or to have myself described – as a trans woman, I have not ever chosen to describe myself – or to be described – as a trans woman and I don’t think it’s likely I ever will. My objection is simple; I am a woman first and transgender somewhere far further down the list. I am not ashamed to be transgender – far from it, I honestly believe I am a far stronger person as a result – but it is not a characteristic that I feel defines me any more than the terms caucasian, blonde or tall might apply to you. To me it is simply a trait and not a definition, and as such – to me  – the line that has been used by Radfem 2012 might as well read “women born in the UK living as women”. As such, I’m lead to wonder whether this explicit exclusion of women who are trans at Radfem 2012 – or, for that matter, in any rad-fem spaces – is simply a manifestation of a dislike of the transgender stereotype as opposed to an actual objection to their inclusion.

The argument which seems to be made in defence of this policy is that of a shared upbringing and a common experience, but I have to admit that this baffles me. When you start to consider the almost infinitesimal combinations of inter- and intra- cultural, geographical and demographic differences even amongst a small group of people, it’s not hard to accept that early experiences are going to vary significantly between any two people. Even if you take a smaller subset – taking culture, geography and demographics out of the equation – then you still need to consider the even larger number of possible individual differences. Some people may have grown up with two parents, some with just one, others still with 3 or 4 or (in the case of one girl I know) 5; some were raised with siblings, others were not; some experienced unexpected deaths, illness or tragedies whilst others were blessed in that regard; the list goes on. When it comes down to it we’re all different – even if this is – such as might be the case may be with twins – down to something as simple as the result of the countless chance interactions we have every day. And if you don’t believe that we are the product of our experiences then genetics just makes these differences quantifiable…

So with this in mind, for this argument to be tangible this leaves one of two options; either there is something magical about the second X chromosome which overrides all other differences, or there is a small series of experiences which must be shared by all women who are not trans – regardless of any environmental factors. Considering first genetics, I end up wondering “Well, what about men who are trans or, for that matter, Kleinfelter’s males?” – clearly these people have the aforementioned magic second X chromosome and yet you would not consider these people to be women by any measure. Ergo, I struggle to accept that it is as simple as this.

So, what about this series of shared experiences which is independent of environmental difference. Well, thinking about it the only way that these experiences could be shared the world over would be if they were biologically determined, at which point we end up discussing differences between males and females. If you consider women who are trans who underwent transition prior to puberty – and thus were raised female – then you can immediately discount socialisation [remember, this is a blanket ban…]. Even if you weren’t to do so, socialisation is so varied depending on where you were brought up, who raised you and what was going on in the world immediately around you that finding this universal shared experience would be a task akin to finding a very small needle in an almost infinitesimal number of very large haystacks. So then, biology?

Due to the affects of hormone replacement, individuals who are trans effectively undergo a second puberty meaning that the only experience which natal women have which women who are trans do not would be menarche. However, again, this is not something which – unfortunately – all natal women will experience due to a number of developmental conditions which can result in primary amenorrhoea. In some cases this is medically correctable but in many cases it is not. This does not make these people any less female; it simply makes them unfortunate and deserving of whatever help we can provide to them.

So, this leads me back to my initial concern – is this simply transphobia at a community level? Worst still, is it that particularly dangerous brand of American transphobia trying to travel across the atlantic? Even if it is not, the danger is that by including this statement they set a precedent wherein it becomes normal for the Radfem community to discriminate again women who are trans and thus helps to make transgender discrimination justifiable to members of its community. I am never one to assume the worst of people, and thus would love to believe that this is just a policy which has been implemented with the best of intentions but a lack of consideration of possible consequences and ramifications. Unfortunately the fact that they have also given a platform to a speaker who is well known for being fiercely anti-trans makes this incredibly difficult to accept, and instead makes me concerned that parts of this conference have the potential to become a sermon of hatred, when they should be trying to facilitate much needed change. As such, I would urge the organisers to reconsider their exclusionary policy but I fear my cries may fall on deaf ears.

On the nature of stealth…

Stealth is a concept which has always left me divided.

On the one hand, being stealth offers protection. Whilst some might argue that this is at the cost of deception, I would instead posit that doing so is actually being as true to those around you as it is possible to be. The past, after all is just that – passed – and has very little baring on present, and thus has little or no effect on the lives of those who surround you despite what they might believe. In many way, this origin is not actually objectionable by nature but instead encourages people to paint you the brush of whatever preconceptions they may hold – founded or unfounded; negative or otherwise. Consequently, revealing this does not so much generate prejudice as it does encourage the polarisation of viewpoints; thus catalysing the witch hunt.

The cost, however, is invisibility. I am left in a position where I cannot be open about my experiences and use them to educate those around me to the extent I would like, despite both their apparent willingness to learn as well as the feeling that they would benefit from my knowledge.  I am not able to fight for my own rights as effectively as I would like, and I am l left on the proverbial sidelines – merely in an advisory capacity – when those around to me are able to engage themselves fully in these battles. In many ways it is infuriating, however I concede its necessity in order to protect myself. Maybe one day the world will reach a level of acceptance when this will not be the case, but for now I must accept that my hands are tied.

This does not mean I have been left powerless. I am still able to educate, inform and increase awareness as someone who is known to be an ally. I hope that my endeavours will have helped to change the way that a significant number of young doctors perceive trans* individuals as well as their ability to provide them with treatment. I hope that I can continue to apply pressure to have this added to the curricula taught to young doctors in a hope that the horror stories I am constantly regaled with become a thing of the past. Whilst I feel this goal is achievable, I am very aware of how difficult it will be to realise. The difference it could potentially make in the years that followed would be more than worth the effort, however.